North Texas Dentistry Volume 8 Issue 4 2018 ISSUE 4 DE | Page 27

resuscitative agents, a positive pressure ventilation device capable of delivering high flow oxygen with appropriately sized facemasks, advanced airways, appropri- ate monitors, and equipment such as stethoscope, pulse oximeter, sphygmo- manometer or automatic blood pressure monitor, portable backup suction and lighting system in an event of general power failure. These requirements apply based on the level of sedation permits held. Additional items may be required for higher level permit holders. Please visit www.tsbde.texas.gov for more information. Sedation/Anesthesia of High-Risk Patients (Rule 110.16): A permit holder may not administer sedation/anesthesia under a level 2, level 3, or level 4 permit to a high-risk patient, defined as ASA III or IV based on the American Society of Anes- thesiologists Physical Status unless the permit holder has completed either a uni- versity or hospital-based residency of at least 12 months in length (grandfathered) or a board-approved educational program that includes a minimum of 16 hours of didactic training in sedation of high-risk patients along with satisfactory manage- ment of sedation in at least 10 cases involv- ing high-risk patients. All cases may be completed through a high-fidelity seda- tion/emergency simulation program. The requirements for this rule do not go into effect until September 1, 2019. Sedation/Anesthesia of Pediatric Patients (Rule 110.17): A permit holder may not administer sedation under a level 2, level 3, or level 4 permit to a pedi- atric patient defined as younger than 13 years of age unless the permit holder has completed either a university or hospital- based residency of at least 12 months in length (grandfathered) or a board- approved educational program that includes a minimum of 16 hours of didac- tic training in sedation of pediatric patients along with satisfactory manage- ment of sedation in at least 15 cases involving pediatric patients where no more than 7 cases are observed on live patients, and at least 8 cases are per- formed as part of a hands-on, high- fidelity emergency/sedation simulation program. The requirements for this rule do not go into effect until September 1, 2019. Inspection of Sedation/Anesthesia Providers (Rule 110.18): The TSBDE may conduct inspections of a licensee, equipment and any document required by TSBDE rules. The inspections process will be limited to the applicable seda- tion/anesthesia rules in effect for each permit level at the time of the inspection. There will be at least 10 business days’ notice before conducting an on-site inspection. All level 2, 3 and 4 permit holders will be subject to at least one inspection prior to September 1, 2022 unless they received their initial sedation permit after March 1, 2018 in which case they will be inspected within a year. The initial inspection will be a compli- ance inspection, in which a Board staff member will evaluate the permit holder’s compliance through completing a check- list and auditing one sedation/anesthesia record of the inspector’s choosing, which was completed prior to the date the licensee was notified of the inspection. If the inspection results in the identifica- tion of a violation, the permit holder must immediately cease providing seda- tion/anesthesia services until satisfactory proof is provided to Board staff that the violation has been corrected. A failure by Board staff to respond within two busi- ness days to permit holder’s satisfactory proof of remediation shall represent an affirmative defense to disciplinary action. Additionally, the permit holder shall pay an amount of not more than $500 to cover the expenses of additional review and inspection by Board staff as a result of any violations identified during the ini- tial inspection. The Board will also develop and admin- ister an online jurisprudence examina- tion to determine a permit holder’s knowledge of the Dental Practice Act, Board rules, and other applicable laws relating to the administration of seda- tion/anesthesia. All permit holders must pass the online jurisprudence examina- tion once every five years. For more information and details on all recently adopted board rules please visit www.tsbde.texas.gov. Dr. Shawn Seifikar is a dentist anesthe- siologist and a mem- ber of the Texas Dental Review Com- mittee appointed by Governor Abbott. He is an adjunct faculty at Texas A&M Col- lege of Dentistry’s Graduate Periodontics Department and President of Southwest Sedation Education. W: www.swsedationeducation.com E: [email protected] P: [phone] www.northtexasdentistry.com | NORTH TEXAS DENTISTRY 27